Galson Named Brutsche Award Winner by wuxiangyu


									          C   O   M    M   I   S   S   I   O   N   E   D      O   F   F   I   C   E   R   S       A   S   S   O   C   I   A   T   I   O   N

Vol. 45, Issue 9                               Salus Populi Suprema Lex Este                                                          October 2008

                                                   Galson Named Brutsche Award Winner
  CRs, HAMRs, and                                  R   ADM Steven K. Galson, USPHS,
                                                       United States Surgeon General (Acting)
                                                   was awarded the 2008 RADM Robert
  Headaches                                        Brutsche Award by the Commissioned
  Dear COA and COF Friends,                        Officers Association Board of Directors at
                                                   the COA/COF Board dinner held in
                                                   Bethesda, Maryland on September 12,
                   T    he news will be
                        old by the time
                     you read this, but
                                                   2008. Named in honor of RADM Robert
                                                   Brutsche, USPHS (Ret.), former national
                     the likelihood that           president and committed and active mem-
                     Congress will pass a          ber of COA, the award is given to a COA
                     massive Continuing            member who has exhibited exceptional
  Jerry Farrell      Resolution (CR) to            commitment to the COA.
  Executive Director
                     keep the government               Immediately upon assuming command
  in business after the end of the fiscal          of the Public Health Service Commissioned
  year on September 30th is all but a              Corps in October of 2007, RADM Galson
  certainty. That is not good news for             demonstrated his commitment to the
                                                                                                      Jerry Farrell, COA Executive Director (left)
  the Commissioned Corps.                          Corps and the COA by actively and success-
                                                                                                      giving RADM Steven K. Galson, USPHS,
      The three main questions that                fully working to raise the maximum limit of
                                                                                                      U.S. Surgeon General (Acting) (right) 2008
  remain to be answered are how                    PHS funded attendees at the 2008 US PHS
                                                                                                      RADM Robert Brutsche Award
  much other “stuff” Congress will try             Scientific and Training Symposium in
  and add to the CR before they leave              Tucson, AZ. The symposium is the only
  town; the duration of the CR; and                annual event focused on bringing together          ment to the Commissioned Corps and by
  whether or not the President will sup-           the officers of the Commissioned Corps             extension to the goals and mission of the
  port what the Hill sends him to sign.            and offers an incomparable range of contin-        Commissioned Officers Association.
      With the final outcome of the                uing education seminars on the latest trends       Thanks to Surgeon General Galson’s sup-
  financial crisis facing the country still        and innovations in public health care deliv-       port, the 2008 Tucson Symposium was the
  unclear, there are an abundance of               ery, administration and research, emergency        second largest in the 42 year history of this
  special interests trying to ensure that          preparedness and crisis response, all of           event and provided one of the finest scien-
  Uncle Sam takes care of them too.                which are vital to maintaining the profes-         tific and training agendas in recent memo-
  Loans for the auto industry, new                 sionalism of the Corps.                            ry.
  offshore drilling rules, and disaster                Admiral Galson’s actions to ensure the             The Brutsche Award recipient’s name is
  relief funding are examples of some              maximum number of officers would be able           enrolled on a plaque permanently displayed
  the items under consideration for                to attend the 2008 symposium reversed a            in the COA national office. Each recipient
  inclusion. Also on the table are a               trend in which the Department of Health            receives a marble paperweight engraved
  dozen more “emergency spending”                  and Human Services was approving fewer             with the likeness of RADM Brutsche, and
  appropriations that include $150 mil-            officers to attend each year. His positive         the inscription “For exceptional service to
  lion for FDA salaries and expenses.              measures clearly demonstrate his commit-           the Commissioned Officers Association.”
      For most accounts, a continuing
                                                                  COF’s DC Combined Campaign Number is 42884.
     (See Executive Dir ector, page 17)                              See related note on page 14 of this issue.

                                                                                                          OCTOBER 2008 • COA FRONTLINE           1
                                                   LEGISLATIVE UPDATE
         COA MEMBERSHIP                           Distracted 110th Congress Nears End,
    CAPITOL HILL REPRESENTATION                   Leaving Much of its Work Unfinished
         COA legislation on Capitol Hill
     continually supports all Commissioned
        Corps officers – active, inactive
              reserve, and retired.               E  ven before the mind-boggling prob-
                                                     lems on Wall Street overtook every-
                                                  thing else on the congressional agenda,
                                                                                                      The Institute of Medicine (IOM), a
                                                                                                  unit of the National Academies, has under-
                                                                                                  taken a fast-track study to examine the mis-
         LOCAL REPRESENTATION                     the 110th Congress was well behind               sion, governance, and organizational struc-
           COA branches generate new              schedule on such fundamental mat-                 ture of the Department of Health and
     venues for meeting fellow officers within    ters as passing appropriations bills to            Human Services. Titled (at least for now)
    your local area while providing a forum for   fund major agencies of the federal                  Improving the Organization of the U.S.
        the discussion of concerns within
                                                  government, including the De-                           Department of Health and Human
            the Commissioned Corps.
                                                  partment of Defense and the                               Services (DHHS) to Advance the
             ANNUAL MEETING                       Department of Health and                                   Health of Our Population, the
    With a mixture of business and pleasure,
                                                  Human Services.                                              study’s report will identify ways
    COA’s annual meeting invites colleagues           When that happens,                                          to help the Department
      from around the country to gather to        Congress resorts to adopting                                       meet the public health
      discuss new scientific presentations        continuing resolutions, or                                          challenges and health
     while stimulating open forums about
                                                  CRs, to keep govern-                                                 care cost challenges fac-
             health-related issues.
                                                  ment agencies func-                                                   ing the nation. The 15-
         INSURANCE PROGRAMS                       tioning until appro-                                                 member study com-
            COA enables members to
                                                  priations bills are                                                 mittee has been asked to
          participate in several low-cost         approved. (The unpalat-                                            formulate both long-term
          insurance programs that may             able alternative is a govern-                                      recommendations and
        continue after leaving the PHS as         ment shutdown.) A CR                                              those that are short-term
        long as your membership in COA                                                                              and administratively feas-
                                                  means funding at previous
                 remains current.
                                                  levels, with no new money for anything.         ible. COA has forwarded its own recom-
                                                      Despite all, COA legislative advocacy       mendations to the study committee, which
                                                  continues. COA has scheduled three              is expected to finish its work by the end of
           COA’s newsletter reports on
          monthly activities and items of         important meetings on Capitol Hill and          the year.
         interest to COA members about            has offered information and perspective to
                the Corps & COA.                  two organizations that are developing           Capitol Hill Meetings
                                                  reports and recommendations for the new
         SCHOLARSHIP PROGRAM                                                                          As Frontline goes to press, COA is look-
                                                  Congress that begins in January.
         COA offers thousands of dollars                                                          ing forward to three key meetings on
          towards college scholarships                                                            Capitol Hill.
           for children and spouses of
                                                  Upcoming Reports                                    COA Executive Director Jerry Farrell
                  COA members.                       Trust for America’s Health (TFAH),           and RADM Jerry Michael (Ret.) are meet-
                                                  the health policy think tank funded by the      ing with Senator Daniel Akaka (D-HI),
      PUBLIC HEALTH PUBLICATION                   Robert Wood Johnson Foundation, is              who chairs the U.S. Senate’s Committee on
              DISCOUNTS                           putting the finishing touches on its latest     Veterans Affairs. The agenda is broad, but a
      COA members receive a 10% discount          report, Blueprint for a Healthier America:      major point is the unfortunate fact that
    on subscriptions to Public Health Reports,
                                                  Recommendations for Modernizing the             PHS officers have been left out of the
     the journal of the Public Health Service;
     and discounts of up to 50% on selected       Federal Public Health System. A draft is cir-   recently-passed law known as the new GI
    materials available from the Public Health    culating among organizations who provid-        Bill. The personal meeting with Sen. Akaka
       Foundation. Visit the COA website for      ed data and information, including COA.         himself is a follow-up to COA's meeting
                more information.                 The report is the result of a year-long, con-   with key congressional staff in July. At that
                                                  sensus-building process that involved 115       time, Jerry Farrell and I met with Sen. Jim
                                                  health experts and organizations. It will       Webb's adviser on veterans' affairs and with
        Members enjoy discount rates on
                                                  focus on ways to address the health work-       staff of the Senate's veterans' affairs com-
          Hertz rental throughout the
        United States at Hertz locations
                                                  force crisis, including specific recommen-      mittee. Although these staff experts had
          and participating licensees.            dations pertaining to the PHS Commis-
                                                  sioned Corps.                                              (See Legislative Update, page 12)

PHS Officers Making a Difference with Mercy
By CAPT Bob Smith, USPHS

O   n May 20, 2008, a team of officers from
    the USPHS descended upon the USNS
Mercy (T-AH 19), which was pier side at
                                                                                                 communities. There were a total of 10 treat-
                                                                                                 ment days and we were overwhelmed by the
                                                                                                 kindness and desire of the people of Samar
the Naval Base in Guam. This was the                                                             to make sure we had what we needed to pro-
beginning of a four month tour to five                                                           vide the medical assistance which was our
nations which in the end would help thou-                                                        mission. I was placed in charge of the
sands of patients. In all, teams from the                                                        Dental portion of the mission and we were
USPHS performed their duties onboard                                                             able to produce some spectacular results.
and onshore under the leadership of the                                                          During the 10 treatment days on Samar,
Officer in Charge (OIC) CAPT Kevin                                                               there were 2,679 patients seen by dental and
Prohaska. The team’s primary focus was the                                                       4,855 teeth extracted and a total of 9,489
provision of oral health and primary care                                                        procedures completed.
services ashore in the smaller outlying vil-                                                         While completing our mission we
lages near the port.                                                                             received word that the ship had cancelled the
    I was the dentist for Team 1. Since this                                                     last mission on shore in Southern Mindanao
was my second deployment with the US                                                             because one of our SH-60 Seahawk helicop-
Navy and the first was on the USNS                                                               ters had been hit by small arms fire upon
Comfort (T-AH 20), I was able to orient                                                          returning to the ship. The holes in the tail
myself quickly because the ships are essen-                                                      section just missed a hydraulic line which
tially identical. I had not been expecting to                                                    could have had a devastating result. Due to
deploy this summer and it came as quite a       Two dentists part of the mission working         the fact that one helicopter was taken out of
surprise to be catching a flight to Southeast   on a little girl's teeth                         service, we were going to have to change the
Aisa to meet up with my fellow officers.                                                         way we would be returning to the Mercy.
                                                dance troop that performed some tradition-
The first few days were spent integrating                                                        Luckily, all went well for us on the mission
                                                al dances on the tarmac. We were invited to
into the dental department and trying to                                                         and we were able to return to the Mercy
                                                join in with the dancers and were welcomed
find out what the mission goals were.                                                            without incident. I returned to the dental
                                                with open arms by those at the airport.
During my initial discussions with CAPT                                                          department, gave my report and was dis-
                                                Over the next 16 days we moved around
Terrance Leary and LCDR Ralph Raya,                                                                                      (See Mercy, page 4)
                                                the island treating patients in four different
they requested that I brief the department
with what had taken place on past deploy-
ments and what to expect when the “boots
were on the ground.”
    The first mission was to the Republic of
the Philippines and our normal daily opera-
tions briefs were infused with warnings of
hostile groups that were operating on the
southern islands, mainly in the Mindanao
area. I was unaware that there are 7,107
islands that make up the Philippine archi-
pelago and that Filipino and English are the
official languages of the Philippines, but
more than 180 languages and dialects are
spoken in the archipelago. The language
issue was going to become a dilemma on a
more recurrent basis in the future.
    I was sent on a Remain Over Night
(RON) mission to the Island of Samar. On
May 30, 2008 we put on our Kevlar and
went by armed convoy to an airport where
we boarded a C-130 and flew to Samar to
begin the mission. We were greeted at the
airport by hundreds of people and a small       The team of officers aboard the USNS Mercy

                                                                                                    OCTOBER 2008 • COA FRONTLINE           3
(Mercy, from page 3)
missed to go to the mess hall, clean up and
get my clothes to the laundry. I must say
that the shower I had on the ship upon my
two week odyssey was one of the best show-
ers of my life. The only other shower that
made such an impression on me was one on
the Comfort right after the Shellback
Ceremony. That one was great due to the
fact of being so cold after enduring the rite
of passage “Crossing the Line.”
    The next mission for us was Vietnam.
This was a totally different mission than
any I have experienced before. Again, we
were scheduled for 10 treatment days
onshore and we were anchored near the
Port of Nha Trang. Nha Trang is the capi-
tal of Khánh Hòa province, on the south
central coast of Vietnam. It was absolutely
beautiful, white beaches and very clean. All
of the missions that took place in Vietnam
were day trips. We would take bandaid           The dance troop greeting we received when we arrived on the Island of Samar
boats to the pier, and then pass through
immigration every morning, then on to the       done. There were 500 patients identified to   and we were able to complete the operation
trucks, and finally onto our buses with the     be seen at each treatment site. All aspects   with great success. The Vietnamese people
names of the schools we were going to.          were very orderly and directed by those at    gained a positive insight to my shipmates
Everything was very controlled, as you          the compound. The US Navy band played         and me, as well as the United States and I
could imagine.                                  at one of my mission sites and it was the     felt that we laid the groundwork for future
    In dental, we were given the names of 50    first time in 35 years that the band had      missions to aid the people of Vietnam.
people each morning for which we were to        played on Vietnamese soil. I think there          With my part of the mission over, all we
provide treatment. Each patient had to          were a lot of firsts that happened on this    had to do was make port in Singapore.
present a letter from the Peoples Com-          mission to Vietnam. Overall, after a slow     Along the way, I was surprised with an
mittee to be allowed to have the treatment      start, the mission went off without a hitch   announcement from the OIC to our group
                                                                                              that he, with the help of other USPHS offi-
                                                                                              cers, had scheduled a promotion ceremony
                                                                                              at sea for me, two other USPHS officers,
                                                                                              and a naval officer. The ceremony was
                                                                                              topped off with the Navy band playing the
                                                                                              USPHS hymn. It was definitely a day to
                                                                                                  On this deployment, the USNS Mercy
                                                                                              visited five nations and treated over 90,000
                                                                                              people. 26 engineering projects ranging
                                                                                              from building a wall to an entire medical
                                                                                              clinic were completed. Health care profes-
                                                                                              sionals from 10 different countries were
                                                                                              involved. My experiences on these past two
                                                                                              deployments with the Navy have been unbe-
                                                                                              lievable. There were times that were very
                                                                                              difficult, strenuous and dangerous, but I feel
                                                                                              the most important message that I could
                                                                                              leave is that these missions are extremely
                                                                                              rewarding, and can give you some insight
                                                                                              into yourself that you may never get in any
                                                                                              other way.
Team of USPHS and Navy dentist officers working on the Island of Samar

A Day of Excitement as Region IV Holds Promotion Ceremony
for RADM Clara H. Cobb Before 250 Guests in Atlanta
By Lee Townsend

R   ADM Clara Henderson Cobb was for-
    mally promoted to her present rank on
April 2, 2008 in an elaborate ceremony in
                                                                                    that the audience would have a greater
                                                                                    understanding and appreciation for the US
                                                                                    Public Health Service.
front of some 250 guests at the PHS Region                                              RADM Williams administered the Oath
IV headquarters in Atlanta , GA. Senior                                             of Office while Admiral Cobb’s parents,
officials presiding over the promotion cere-                                        George and Emma Henderson, held the
mony were Principal Deputy Assistant                                                Bible. Her husband Milton, and daughter
Secretary for Health, Dr. Don Wright and                                            Chelsea removed Captain Cobb’s shoulder
Acting Deputy Surgeon General, RADM                                                 boards and replaced them with Rear
Robert C. Williams.                                                                 Admiral Cobb’s new ones. Her two older
    The official party was announced with                                           brothers assisted the new admiral in don-
traditional boat gongs, sideboys, and the                                           ning her new service dress blue blouse with
boastswain’s call. The Colors were advanced                                         its broad gold stripes.
by the Honor Cadre, the National Anthem                                                 Following the presentation and posting
was sung by “Dedication” a sextet a cappel-                                         of RADM Cobb’s personal flag, she
la harmonizing group of men, friends of                                             addressed the crowd. She spoke of her sur-
RADM Cobb. Mr. Wintley A. Phipps, a                                                 prise and excitement when, on September
renowned gospel vocalist, sang the invoca-                                          26th, 2007 she learned in a telephone call
tion.                                                                               with former Acting Surgeon General Ken
    Retired RADM Jarrett Clinton, RADM                                              Moritsugu that she had been selected for
Cobb’s immediate predecessor as Regional                                            promotion to flag rank – effective four days
Health Administrator, delivered a warm                                              later on October 1st. Three days after her
and informative presentation about the ori-    RADM Robert C. Williams, Acting      promotion she participated as a flag officer
gin of the Corps and the distinction           Deputy Surgeon General and RADM      in Admiral Moritsugu’s retirement ceremo-
between the seven uniformed services so        Clara Henderson Cobb                 ny.
                                                                                        Admiral Cobb went on to relate the
                                                                                    story of how a shuttle bus operator at the
                                                                                    Atlanta Hartsfield-Jackson airport had fore-
                                                                                    cast her promotion to “general” two years
                                                                                    earlier while driving the then “colonel” to
                                                                                    her car – the first female “colonel” he had
                                                                                    ever encountered. It was one of those teach-
                                                                                    able moments. After her promotion,
                                                                                    Admiral Cobb sought out this seer and was
                                                                                    pleased to have him present at her promo-
                                                                                    tion ceremony.
                                                                                        Special presentations were made to
                                                                                    Admiral Cobb by Dr. Renee Winkfield,
                                                                                    Chair of the Edyth T. James Nursing
                                                                                    Department of Columbia Union College,
                                                                                    Takoma Park, MD; Karen Ashton,
                                                                                    Executive Officer on behalf of the Regional
                                                                                    Director; and Sharon Ricks, Deputy
                                                                                    Regional Health Administrator, on behalf
                                                                                    of the entire Region IV Office of Public
                                                                                    Health and Science.
                                                                                        RADM Cobb’s youngest brother was the
RADM Robert C. Williams, Acting Deputy Surgeon General and Chelsea Henderson Cobb   final speaker. He shared some of the more
assist with the changing of RADM Cobb's shoulder boards.                                                      (See Cobb, page 6)

                                                                                       OCTOBER 2008 • COA FRONTLINE           5
(Cobb, from page 5)                             ing Alabama, Florida, Georgia, Kentucky,              RETIRED COLUMN
                                                Mississippi, North Carolina, South Caro-
intimate details regarding his experience
with his sister as they were growing up that
                                                lina and Tennessee.
                                                    In May 2008, she assumed additional           Attention Retired
brought much joy and laughter to the audi-
ence but kept RADM Cobb somewhat on
                                                responsibilities as Acting Regional Director
                                                for Region IV where she serves as a Regional
                                                                                                  and Soon-to-be-
the edge of her seat in anticipation.
    The Benediction was performed in song.
                                                Representative for Intergovernmental
                                                Affairs. In this role, she represents the
                                                                                                  Retired Officers
RADM Cobb is a member of a women’s              Secretary of the Department of Health and
group, “A Special Blend.” A surprise to all,
she joined the group as they joined with
                                                Human Services in direct official dealings
                                                with State, Local and Tribal government
                                                                                                  I n order to be eligible for TRICARE for
                                                                                                    Life health insurance, you must sign up for
                                                                                                  Medicare Part B when electing your social
“Dedication” to sing, “A Parting Blessing.”     organizations and maintains effective work-
    RADM Cobb is grateful for the support                                                         security and Medicare benefits. Retired offi-
                                                ing relationships with Governors, Mayors
of everyone who helped plan the promotion                                                         cers and spouses over age 65 are no longer
                                                and other key State, Local and Tribal offi-
ceremony, especially CDR Edecia Richards,                                                         eligible for TRICARE Prime. At age 65, the
the PHS Ensemble and Chorale, ushers,                                                             principal payer for health insurance claims
                                                    RADM Cobb is also the Co-chair of the
sideboys, boatswain, and more.                                                                    shifts to Medicare with TRICARE for Life
                                                Scientific Program Planning Committee for
    RADM Cobb has completed 29 years of                                                           as second payer. In most cases, retirees and
                                                the 2009 COF/COA U.S. Public Health
active duty service. She currently serves as                                                      spouses can continue to obtain primary care
                                                Service Scientific and Training Symposium
the Regional Health Administrator for the                                                         at the same medical treatment facility where
                                                which will be held in Atlanta, Georgia (May
Department of Health and Human                                                                    enrolled under TRICARE Prime. Visit the
                                                31 – June 5). She invites every commis-
Services, Region IV. She is the principal                                                         TRICARE website at http://www.tricare.
                                                sioned officer, civilian colleagues, family
federal public health leader in Atlanta,                                                          mil/ for details.
                                                and friends to attend what will undoubted-
reporting directly to the Assistant Secretary   ly be the greatest meeting ever, so please save
for Health. She provides executive level        the date and make plans today to attend.
leadership in policy development, planning      She and the planning committee members
implementation and evaluation of public                                                                 WELCOME NEW COA MEMBERS
                                                look forward to seeing each of you there.
health programs and directs five regionally     Her message to all is, “Have a Healthy                LT Kevin A. Bates, DC
based programs designed to protect and          Day!”                                                 LCDR Suzanne F. Beavers, ATLANTA
promote the health of all communities                                                                 LT Todd A. Campbell, ABERDEEN
within the eight southeastern states, includ-                                                         LCDR Carlos Castillo, DC
                                                                                                      LT Tonya G. Cornwell, CATAWBA
                                                                                                      LTJG Michelle M. Dittrich, KILLERWHALE
                                                                                                      LCDR Erica L. Graham, NCAROLINA
                                                                                                      LT Cria O. Gregory, ATLANTA
                                                                                                      LT Benjamin J. Gueck, GRANDCANYON
                                                                                                      LT Jeremy W. Hargrove, UNAFFILIATED
                                                                                                      LT Shayna M. Herbert, DC
                                                                                                      LTJG Solveig F. Johnson, AURORA
                                                                                                      ENS James C. Lee, DALLAS
                                                                                                      LT Kyle Lim, TIDEWATER
                                                                                                      LT Jeffrey S. McCoy, CNTRL_OREGON
                                                                                                      LT D'Angela G. Merrell, GREENCOUNTRY
                                                                                                      LT Vera C. Moses, GRANDCANYON
                                                                                                      LT Maria T. Nguyen, DC
                                                                                                      LTJG Jason A. Petersen, UNAFFILIATED
                                                                                                      LTJG Regina Y. Peterson, UNAFFILIATED
                                                                                                      LTJG Carolyn T. Pumares, GRANDCANYON
                                                                                                      LTJG Merideth Rose, BALTIMORE
                                                                                                      LT Richard P. Schobitz, DC
                                                                                                      LT Amanda Stewart-Wright, UNAFFILIATED
                                                                                                      LT Stephanie L. Victor, DC
                                                                                                      LTJG Daniel L. Wagoner, OKLAHOMA
                                                                                                      LT Yvette Waples, DC
                                                                                                      LCDR Mary A. Wenck, ATLANTA
                                                                                                      LT Amy R. Whisler, AURORA
                                                                                                      LT Lori A. Wiggins, BALTIMORE
(left to right) RADM Bob Williams, CDR Bruce Tierney, RADM Clara Henderson Cobb                       ENS Xi Hua Yang, UNAFFILIATED
hugging her parents George and Emma Henderson, husband Milton and daughter Chelsea.

Outgoing COA Board Chair and COF President Recognized for Service
T  he combined boards of the Com-
   missioned Officers Association and PHS
Commissioned Officers Foundation recog-
nized the service of outgoing Association
Chair, CDR Daphne Moffett and Foun-
dation President, retired RADM Mary Pat
Couig during the COA/COF Board
Dinner on September 12, 2008 in
Bethesda, Maryland.
    CDR Moffett is the Scientist Category
representative on the COA Board of
Directors and served previously as the
Chair-Elect. During CDR Moffett’s term
as Board Chair COA began an extensive
strategic planning process; organized the       (left to right) RADM Mary Pat Couig and        COA Executive Director Jerry Farrell
second-ever PHS Commissioned Corps              Jerry Farrell at the COA/COF Board             presents outgoing COA Board Chair CDR
change-of –command ceremony; expanded           Dinner                                         Daphne B. Moffett the stand for her gavel
its partnership network by joining the
National Health Council and other public        expressed the appreciation of the Board of     ducted the second Global Health Summit
health advocacy groups; and forging closer      Directors for CDR Moffett’s exceptional        in June 2007 attracting speakers and partic-
working relationships with groups like the      leadership through a challenging year.         ipants from around the world to address the
Trust for America’s Health.                     Farrell presented CDR Moffett with an          importance of health diplomacy as a path to
    Under CDR Moffett’s leadership COA          engraved wooden stand for the gavel she        world peace and prosperity.
has successfully weathered an austere and       wielded as Board Chair. Incoming COA               In an effort to put the lessons learned at
challenging fiscal climate completing a fifth   Board Chair, CAPT Mary Lambert was             our Global Health Summit to work, the
straight year of balanced budgeting. The        presented with a new gavel to use during the   Foundation entered into a formal relation-
Association also added new membership           current year.                                  ship with the Chinese Association of Health
benefits with member discounts negotiated          RADM Couig completed two years as           Education in Beijing. The Foundation,
for subscriptions to the journal Public         President of the PHS Commissioned              partnering with the School of Public Health
Health Reports and selected publications of     Officers Foundation Board of Trustees.         at the University of Maryland, agreed to
the Public Health Foundation.                   During her tenure as President, RADM           collaborate on a project examining the role
    COA executive director Jerry Farrell        Couig oversaw the transfer of responsibility   of nurses as health educators in a rural set-
                                                for the Annual Scientific and Training         ting.
                                                Symposium from the COA to the COF.                 COF also established a program to stim-
                                                Also during her term the Foundation con-       ulate the graduate education of Com-
                                                                                               missioned Corps officers. That program has
                                                                                               been formalized as the RADM Jerrold M.
                                                                                               Michael Fellowship. The first six Michael
                                                                                               Fellows have recently completed a semester’s
                                                                                               work at the University of South Florida,
                                                                                               College of Public Health.
                                                                                                   RADM Couig’s term as President of the
                                                                                               Board has been both challenging and
                                                                                               rewarding. Foundation executive director
                                                                                               Jerry Farrell thanked Admiral Couig on
                                                                                               behalf of the Foundation Board of Trustees
Incoming Foundation President, CAPT                                                            and presented her with a small gift of appre-
Jim Knoben and outgoing President                                                              ciation.
RADM Mary Pat Couig present Executive                                                              Both CDR Moffett and RADM Couig
Director, Jerry Farrell with a Waterford                                                       will continue to serve on the respective
Crystal Vase to display in Foundation           COA Executive Director Jerry Farrell           COA and COF boards until their three-
headquarters as an expression of apprecia-      presents incoming COA Board Chair              year terms of office are completed.
tion for the work of the Foundation staff       CAPT Mary Lambert the Chair's gavel

                                                                                                  OCTOBER 2008 • COA FRONTLINE             7
Call for Abstracts Announced for 2009 Symposium
T  he 2009 USPHS Scientific & Training
   Symposium agenda planning committee
invites interested individuals to submit
                                                     the public health workforce?
                                                     Culturally competent leadership of the
                                                     public health workforce in an increasing-
                                                                                                        health care reform with an emphasis
                                                                                                        (platform) on Public Health – impact on
                                                                                                        public health workforce requirements
abstracts for consideration as concurrent            ly more diverse society.                         • Providing public health leadership to a
track presentations for the conference,          •   Leading a public health workforce                  global public health workforce
which will be held June 1-4 at the Atlanta           through change, a crisis, or in uncertain-       • The impact of an aging public health
(GA) Marriott Marquis. The theme for the             ty.                                                workforce on providing essential public
2009 conference is Leading a Strong              •   Answering the call - realizing the PH              health services
Public Health Workforce for a Healthy                leader within. Transitioning from patient
America. The deadline for abstract submis-           to community health. Identifying a per-          Track II: Strategies for
sions is November 14, 2008. Visit,                   sonal action plan and career pathway.            Ensuring a Viable and Effective for more informa-           •   Think globally, act locally – how clini-         Public Health Workforce
tion or to submit.                                   cians can best interact with the public             The focus of this track is on preparing
   Submitters should be prepared to make             health leadership and infrastructure.            the public health workforce now and in the
a 30 or 60-minute presentation as part of        •   The rise of a vertically integrated (local to    future. Case studies and examples of the
tracked sessions. The committee currently            global) public health workforce.
anticipates six concurrent tracked sessions      •   Power and Influence- Leading national                       (See Call for Abstracts, page 10)
throughout Wednesday June 3 and
Thursday, June 4. Decisions on approved
abstracts are expected by December 31,
   Abstracts are sought that provide an
                                                     Sex, Sin and Science Offered to COA
opportunity for those engaged at all levels
and settings of public health to share inno-
                                                     Members at Discounted Price!
vative and effective practice and research
that relate to the meeting’s overall theme or
                                                     Former PHS Historian’s Book on History
any of the four sub-themes described below.          of Syphilis in America Now Available
The examples listed below are for illustra-
tion purposes only. Any topics falling with-
in the realm of the overall theme or sub-
theme will be considered.
                                                     J ohn Parascandola’s just published Sex,
                                                       Sin, and Science: A History of Syphilis in
                                                     America is being offered to COA mem-
                                                     bers by the publisher (Praeger) at a dis-
Track 1: Leading the Public                          count of 20% off the list price. Dr.
Health Workforce in America                          Parascandola is the retired Public Health
                                                     Service Historian and a current Trustee
    The focus of this track is on public
                                                     of the Commissioned Officers Foun-
health workforce leadership, trends, strate-
                                                     dation. Dr. Parascandola’s fascinating
gies and needs. Topics can range from pub-
                                                     book traces the history of syphilis in
lic policy issues related to leading and sus-
                                                     America from Colonial times to the
taining a viable public health workforce to
                                                     present, as well as providing a back-
clinician career pathways in becoming a
                                                     ground chapter on the origins and
public health leader. Case studies and
                                                     spread of syphilis. The important role of
examples of leadership and/or successful
                                                     the PHS Commissioned Corps is
public health workforce strategies at all lev-
                                                     prominently featured throughout his
els would be of interest. Example topics
                                                     narrative. In his foreword to the book,
could include:
                                                     17th U.S. Surgeon General Richard H.
• What does it mean to be a Public Health            Carmona calls the work “a thoughtful,
  (PH) leader? Elements of leading a pub-            powerful and revealing treatise…that
  lic health workforce. Developing public            the general public, historians, politi-
  health leaders.                                    cians, and science can benefit from.”
• Projected needs and public policy issues              To learn more about the book and   
  for sustaining a viable public health              receive the 20% discount, go to                 aspx and use discount code F238.
  workforce over the next 25 years. What is

                                                                                                         OCTOBER 2008 • COA FRONTLINE           9
(Call, from page 9)                                                                                   by collaboration with the private sector
                                                                                                      and non-governmental organizations
following possible example topics would be          IN MY VIEW
                                                                                                      (NGOs), people living with HIV/AIDS,
of interest:                                                                                          and people with disabilities.
• Preparing the public health workforce for
  future public health challenges
                                                  Dr. Richmond                                    •   Partnering with faith based communi-
                                                                                                      ties/organizations to address a wide
• Strategies for recruitment and retention        Remembered                                          range of public health issues to achieve
  of public health professionals from                                                                 better health and eliminate disparities
  among the next generation; understand-
  ing generational differences.
• Strategies of addressing the education
                                                  T  hank you for the nice article about
                                                     Dr. Richmond's passing. His pass-
                                                  ing is a great loss for me personally as
                                                                                                  •   Partnering with public health laborato-
                                                                                                      ries to improve frontline defense against
                                                                                                       emerging infectious diseases
  needs of the for developing the next gen-       I had the honor of working with him             •   Public-private partnerships to develop
  eration of public health professionals          as his Deputy Surgeon General.                      strategies for improving US food safety
• Education, training, and credentialing          Unfortunately, due to his low key               •   The importance of partnerships between
  standards for the public health workforce       style,he was not well known by the                  health care and public health
• Standardizing core competencies for the         general public. As the article points
  public health workforce                         out, he made some major contribu-               Track IV: Preparing the Public
• Providing training and real-life experi-        tions to advance the public's health.           Health Workforce for All
  ence to public health students                  He continued to be very active at               Hazards
• Equipping the public health workforce           Harvard right up to the last. He was
  with information technology tools               highly respected and appreciated by                This track is for presentations and dis-
• Didactic and on-line public health work-        his peers as a brilliant and caring             cussions regarding the roles of the public
  force training and development programs         health professional. We became very             health workforce for preparedness and
• Career development for the public health        close personal friends and had fre-             response to all hazards. Case studies and
  professional                                    quent contact until last spring.                examples would be of interest. Example
• Training clinicians to be public health                                                         presentation topics could be as follows:
  leaders                                         Sincerely,                                      • Workforce standards and competencies
• The significant roles of clinicians in pub-                                                       for ESF 8 preparedness and response
  lic health practice                             John C. Greene, DMD, MPH                        • Preparing the workforce for ESF-8 core
• Developing linkages in health care and          Deputy Surgeon General (retired)                  functions (what works, what doesn’t
  public health practice                                                                            work, strategies for future efforts)
• Preparing Public Health Workers for dis-                                                        • Measuring preparedness capability in the
  asters and the aftermath                                                                          workforce
• Information technology and its impact                                                           • Developing a surge capacity for health
  on the public health                            Native American veterans                          workforce, hospitals (treatment and
• Resources for Public Health Workers           • Use of community consortium in the                patient isolation), laboratories, and
  during disasters                                Federal Healthy Start Program                     patient transportation
• Strategies for personal wellness for public   • Corporate involvement to improve com-           • The 2008 hurricanes response experi-
  health workers                                  munity health                                     ence: federal, state, and local public
                                                • Successful partnerships with media to dis-        health workforce coordination
Track III: Partnerships to                        seminate health messages                        • Leveraging all health care workers to
Improve Public Health                           • International, federal, state, and local col-     respond to disasters: Medical Reserve
                                                  laborations to improve health through             Corps, etc.
   This track will focus on areas where lead-     surveillance or innovative programs             • Preparing the public health workforce
ership in partnering, including leveraging of   • Partnering with non-governmental                  for the pandemic flu
people and resources, both domestically and       organizations (NGOs) to facilitate suc-         • Public health legal preparedness for
internationally, can result in more effective     cessful translation of research to practice       emergencies
and efficient public health workforce. Case     • Strategies for constructing effective part-     • Cross sector Federal coordination for
studies and examples of private-public part-      nerships among diverse agencies/organi-           emergency response (HHS, DHS/
nerships, academic and state or local gov-        zations                                           FEMA, FBI)
ernment interactions, NGO and federal or        • Organization and ethical challenges of          • Risk communication for the public
international aid program partnerships, and       partnerships and how to overcome them             health workforce
international collaborative opportunities are   • Developing partnerships with communi-           • Resources/tools/training for emergency
of interest. Example presentation topics          ty health centers for emergency prepared-         preparedness and response
could be as follows:                              ness planning                                   • Special public health missions (e.g.,
• Joint IHS/VA health care programs for         • Expanding the public health workforce             formaldehyde testing in travel trailers)


COA North Central Branch Cooks Up an Amazing Dinner
for the Ronald McDonald House of Rochester, MN
By LT Liatte Krueger, USPHS

O   n August 3, 2008, the COA North
    Central Branch hosted their First
Annual house dinner for the Ronald
McDonald House of Rochester, Min-
nesota. The house, which was once an
idea conceived by four families, has now
blossomed into an organized nonprofit
organization that provides housing for 42
patients and their families, who travel
hundreds to thousands of miles, to seek
medical treatment for their children at
the Mayo Clinic. The Ronald McDonald
House stays true to its mission of main-
taining a “home away from home” for
families by providing shelter and support
to face difficult days and long nights.
   Families who stay at the Ronald
                                             Pictured from back to front, left to right: LCDR Garrett, LT Eaker, CDR Shine, LCDR
McDonald House share their stories and
                                             Wheeler, LT Krueger, LT Walsh, CAPT Keller-Miller, LCDR Feda, LT Witter, and LCDR
              (See North Central, page 12)   Laufenberg

                                                                                            OCTOBER 2008 • COA FRONTLINE      11
(Legislative Update, from page 2)                 to hear first-hand (and counter) the rumored      developing a job description for the new
                                                  reservations of House appropriators.              position and expects to hire someone by the
helped develop the expanded GI bill and                                                             end of the year.
appeared to be sympathetic to COA's posi-
                                                  COA Legislative Committee
tion, they could not assure us that a fix to
                                                     The COA Board of Directors met for its         Thank-You Notes
include the PHS would, in fact, be made.
    COA also is meeting with staff of the         Annual Orientation and Workshop on                    Thanks to Dr. Richard Carmona, for-
House Energy and Commerce Committee               Friday and Saturday, Sept. 12 and 13, in          mer Surgeon General and PHS advocate
to see if there is any possibility of saving at   Bethesda, Maryland. The Board’s Legislative       extraordinaire, who convinced the Ameri-
least some of the elements in HR 3447, the        and Benefits Committee, chaired by CAPT           can Medical Association’s House of
Surgeon General Independence Act, which           Steven R. Rosenthal, has both new and             Delegates to adopt a resolution supporting
has not moved since it was introduced more        returning members. In addition to CAPT            efforts to strengthen the hand of the
than a year ago. It has no chance of passage      Rosenthal, they are: CDR Thomas Addison,          Surgeon General.
before the end of the 110th Congress on           LCDR Michelle Colledge, CAPT Sandra                   Thanks to the active-duty and retired
December 31, so the best possible scenario        Farley, CAPT Carol Friedman, CDR Dana             PHS officers who have let us know they are
is to see something like it reintroduced next     Hall, CDR Chuck Hayden, CAPT Steven               writing to their U.S. Senators and Repre-
year.                                             Libutti, LCDR Jonathan Rash, and CAPT             sentatives to ask them to actively support
    COA has an upcoming meeting with              Craig Wilkins.                                    the inclusion of PHS officers in the new GI
key House Appropriations Subcommittee                In accordance with the COA Strategic           bill. You know who you are! To join this
staff to discuss the non-funding (for the sec-    Plan and follow-up discussions during the         select group, please contact me and I will
ond year in a row), so far, of the proposed       workshop, the Board has approved the hir-         send you a sample letter, writing tips, and
PHS Health and Medical Response                   ing of one additional government relations        other information to make the task easier.
(HAMR) teams. We want an opportunity              specialist in the COA national office. Staff is   Call me toll-free at 866-366-9593 or e-mail
                                                                                                    me at
                                                                                                                             —Judy Rensberger

              NEW 100% Silk, 9” PHS Miniflag                                                        (North Central, from page 11)
         Embroidered on both sides; silk fringe, cord and tassel                                    gain new insights as they meet children
                                                                                                    and parents with similar concerns. The
                 14” Chrome Colored Solid Brass Stand                                               House is a place for guest families to share
                                                                                                    their hopes and dreams. As one of the
                          Sponsored by the DCCOA Branch                                             parents said the night of the dinner, “The
                 LIMITED EDITION –ORDER YOURS NOW                                                   Ronald McDonald House helps to signif-
                                                                                                    icantly ease the stress of trips that many
                                                    Elegant. Great for retirement and               have to take to Rochester. Not only finan-
                                                    promotion gifts, and to “fly” in                cially, but also by making terribly painful
                                                                                                    days bearable.”
                                                    your office. Developed by CAPT
                                                                                                       In support of the Ronald McDonald
                                                    Caviness to increase esprit de
                                                                                                    House and the Public Health Service’s
                                                    corps among officers, and to pro-               commitment to responsible philanthropy,
                                                    mote the Corps. For more infor-                 eleven officers of the branch contributed
                                                    mation:                                         to the buffet style dinner attended by
                                                              approximately 40 family members. The
                                                                             preparation and clean up seemed small
                                                    (240) 276-0648                                  compared to how fantastic it felt to touch
                                                                                                    of lives of these families and their chil-
       $35.00 each (including postage---Mail checks made out to "DCCOA":                            dren, even if it was just to listen and offer
             CAPT Susanne Caviness, 15115 Interlachen Drive, # 921                                  them a smile. We look to make this a reg-
                                 Silver Spring, MD 20906                                            ular event in the future and continuing to
         [Sent fully assembled, wrapped in tissue paper, in a mailing tube]                         support the Ronald McDonald House
                                                                                                    organization. For more information on
                    The DCCOA is also your source for the PHS Coin,                                 the Ronald McDonald House, please feel
                            $10.00 each, and lapel pins.                                            free to visit http://www.ronhouserochmn.

The Case for Force Management, Part Deux –
Are the Stars Really Aligned?
Jerry Farrell, COA Executive Director

T   he phones in COA’s offices started ring-
    ing off the hook again in early September
just after the Department released the new
                                                     ment Official, COT-PER did not. Both are
                                                     SES positions and were recommended by
                                                     CDC. The principal difference between the
                                                                                                         tem in DHHS and expect it to work the
                                                                                                         same way. Either the entire system has to be
                                                                                                         changed to look and operate like the DoD
2008 Flag Grade Billet Evaluation and                two functions is that the budget authority          system, or you have to find an entirely dif-
Designation results. The calls were almost           for the latter is significantly greater than that   ferent process. The Corps needs – must
exclusively from flag officers who all asked a       for the former. Consider as another exam-           have – a force management system that
variant of the same question: What the               ple that the OCCO Director, responsible             works like their counterparts in the Armed
heck is going on? This list makes no sense.          for the operation of Commissioned Corps             Services.
    The first notable change in the new flag         personnel functions – recruiting, distribu-             Perhaps the best place to start is from the
officer billet list is the elimination of all bil-   tion, career development, etc is classified as      top down. Let’s get those stars properly
lets previously designated as O-7/8 billets          an O-7 billet while the OCCFM Director,             aligned first and maybe the rest of the PHS
meaning that an officer could serve in that          who coordinates policy development for the          universe will start to order itself more appro-
particular billet as either an O-7 or O-8 offi-      ASH moves up to an O-8 billet.                      priately. Where to begin? Well, we can start
cer. Such a designation provides the O-7                 Confused? Welcome to the club.                  by including all SES billets as PHS flag des-
officer an opportunity for advancement                   The PHS flag grade billet evaluation            ignated billets. That is how they are defined
without having to change jobs. But the               process currently in place was developed in         in DoD. SES billets are “flag equivalents.”
effect of the change is pretty dramatic.             2005 and requires a review and re-designa-          Not some SES billets. All SES billets.
    Perhaps the greatest impact of this              tion every three years. The process claims to           The PHS thinks of itself as a legacy mar-
change is on the Indian Health Service               mirror the DoD, especially Navy, flag billet        itime or sea service so let’s continue using
(IHS) which previously had a dozen or                review process. A major distinction between         the Navy as an example. The Navy’s uni-
more billets designated as O-7/8. The new            what happens in DoD/Navy and the PHS                formed leader is the Chief of Naval
list provides for one IHS O-8 billet, the IHS        Commissioned Corps is the outcomes of               Operations (CNO). His responsibilities
Deputy Director position, one not current-           the two “parallel” processes.                       include recruiting, training, outfitting and
ly filled by an officer. There are more than             The Navy flag officer billet review does        equipping the naval forces. His equivalent
twice as many officers assigned to IHS as to         not result in wholesale changes to the flag         in the PHS is the Surgeon General. There’s
any other operating division or agency. A            officer distribution every few years, whereas       the first billet.
fair question then is; why does not the dis-         that apparently is what we can expect from              The CNO operates his Navy by assign-
tribution of O-8 officers reflect the overall        the PHS process. This is not a healthy situ-        ing forces to the fleet commanders, of which
population of Commissioned Corps officers            ation for a Corps that is trying to define a        there are currently two – Commander,
in IHS? HRSA, which has one-tenth the                consistent career path for its officers. If         Pacific Fleet and Commander, Atlantic
number of Commissioned Officers assigned             achieving flag rank is a goal officers ought to     Fleet. There is no current equivalent in the
as IHS, has three times as many O-8 billets.         aspire to and shape their careers to achieve,       PHS for these fleet commanders so that is a
    CDC, with not half the number of offi-           it would help if the targets remained consis-       layer of leadership we don’t need. The
cers as IHS, manages to have ten times as            tent from year to year. They surely do in the       Navy’s two fleet commanders further assign
many O-8 billets (10), eleven if ATSDR is            Navy.                                               their forces to the numbered fleet com-
included. FDA and BOP each have more                     COA has been urging the implementa-             manders where the real work gets done.
than 700 but less than 800 officers assigned;        tion of a billet based force management sys-        Today, there are six numbered fleet com-
making them, respectively, the third and             tem as the most fundamental element of a            manders. The PHS equivalent of numbered
fourth largest in terms of PHS officers. But         transformed Corps for several years. The            fleet commanders are the operating divi-
BOP gets no O-8 billet, while FDA gets               inconsistencies apparent in the Flag Grade          sions and agencies where the work gets
four.                                                Billet Evaluation and Designation process           done.
    It’s not just the “upper half” rear admiral      are but the latest reasons in a long list of why        The top leadership positions of these
billets that are causing some heartburn and          this is so critical to the Corps’ future.           CDC’s, NIH’s, FDA’s, IHS’s. etc. are all eli-
raising questions. There’s lots of bewilder-             The good news is that there is a process        gible to be appointed as PHS flag officers.
ment about the distribution of the “lower            in place to determine which positions ought         Heck, back in the day, they ALL WERE
half” O-7 flag billets too.                          to be filled by flag officers in the PHS. The       PHS flag officers appointed by the Surgeon
    Consider, as one example that the CDC            not so good news is that the PHS cannot             General (with the approval of the
Chief Management Official, CCHIS made                adopt one piece of a whole system from              President). Today they are SES positions as
the O-7 list, but the CDC Chief Manage-              DoD, insert it into an entirely different sys-                  (See Force Management, page 19)

                                                                                                             OCTOBER 2008 • COA FRONTLINE           13
PHS Commissioned Officers Foundation
for the Advancement of Public Health Acknowledges...
Donations received August 1st to August 31st, 2008

Gold                                              * In Memory of CAPT Nancy A. Hazleton, (Ret.)
                                                  ** In Memory of CAPT Irving Herbert Schlafman,
Anonymous                                         (Ret.)                                                    Combined Federal
CAPT Patricia D. Mail, (Ret.) *
Unitah Basin COA Branch                                                                                     Campaign Approved
Bronze                                                     Donations Can be Made                                PHS Commissioned Officers
                                                              at Several levels:                            Foundation for the Advancement of
CAPT Louise K. Baker, (Ret.)                                                                                Public Health (COF) has been
CAPT Kent E. Jaffe
CAPT Robert E. McKay, (Ret.) **
                                                                                                            approved to participate in the 2008
                                                     Leadership Society . . . .$10,000                      Combined Federal Campaign of the
CAPT Thomas E. Stenvig, (Ret.)
                                                     President’s Society . . . . .$5,000                    National Capital Area (CFCNCA).
                                                     Founder’s Society . . . . . .$2,500                        The designation (catalog) number
                                                     Platinum . . . . . . . . . . . . . .$1,000             assigned to the Foundation is 42884.
CAPT Carolyn Chapin Blackwood, (Ret.)                Gold . . . . . . . . . . . . . . . . . . .$500         Please keep COF in mind when you
CAPT Alice E. Duncan, (Ret.)
Beth B. Fleet **
                                                     Silver . . . . . . . . . . . . . . . . . .$250         support the 2008 Combined Federal
CAPT Lorenzo G. Guzman, (Ret.)                       Bronze . . . . . . . . . . . . . . . . .$100           Campaign.
CDR Gor Yee Lum

                                                           Yes, I would like to help!

                     P H S C O M M I S S I O N E D O F F I C E R S F O U N D AT I O N
                                    FOR THE       A D VA N C E M E N T           OF     P U B L I C H E A LT H

                                           Enclosed is my contribution                           MAIL TO: PHS Commissioned Officers
                                                                                                          Foundation for the
                                        Please make checks payable to:                                    Advancement of Public Health
                                        “PHS Commissioned Officers Foundation”                            8201 Corporate Drive, Suite 200
                                        or provide credit card information below                          Landover, MD 20785

           Type of Credit Card:         Amount:         $ ____________________
                MasterCard              Card Number:        ________________________________________________________________
                Visa                    Name on Card:       ________________________________________________________________
                American Express        Expiration Date:    ________________________________________________________________
                Discover                Signature:          ________________________________________________________________
                                        Name:               ________________________________________________________________
                                        Organization:       ________________________________________________________________
                                        Mailing Address:    ________________________________________________________________
                                        City:     __________________________ State: ______________ Zip: ______________
                                        Phone:    ____________________ Fax: __________________ Email: __________________

COF Announces Scholarship Winners for 2008
T  en deserving dependents of PHS Com-
   missioned Officers have been awarded
COF sponsored scholarships for the 2008-
                                              University of Southern California working
                                              towards a degree in Architecture. His COA
                                              sponsor is his mother, Captain Marie A.
                                                                                                ing. His COA sponsor is his mother,
                                                                                                Captain Marie A. Schroeder, USPHS.

2009 academic year. Winners were chosen       Schroeder, USPHS.                                 Kayla Meeks, from Tuttle, OK is the winner
by a panel of PHS Commissioned Officers.                                                        of the Rio Grande Branch Scholarship.
                                              Erin Price-Wright, from Phoenix, AZ is the        Kayla attends East Central University, in
                                              winner of the Atlanta Branch Scholarship.         Ada, OK. Her goal is to become a Physical
Congratulations to the following:
                                              Erin has just begun her studies at Stanford       Therapist. Her COA sponsor is her father
Klint Peebles, from Nashville, TN winner      University. Her COA sponsor is LCDR               Captain Kevin Meeks, USPHS.
of one of two Captain Ray D. Crossley II      Deborah Price, USPHS.
scholarships. Klint is presently working                                                        Ashlee Walker, from Germantown, MD is
                                              Preston Tilus, from Tucson, AZ is the win-        the winner of the PHS Commissioned
towards his Neuroscience Degree at
                                              ner of the OBC Class 004 Scholarship.             Officers Foundation Scholarship. Ashlee is
Vanderbilt University. His COA sponsor is
                                              Preston is a student at the University of         just beginning her studies at the University
his father Captain Johnny B. Peebles,
                                              Arizona. His major is Computer Science.           of Maryland, College Park, MD. Her COA
USPHS (Ret).
                                              His COA sponsor is LT Michael Tilus,              sponsor is Captain O’Neal A. Parker,
Laura A. Divel, from Rockville, MD win-       USPHS.                                            USPHS.
ner of the Ronald Lessing Memorial
                                              Caitrin O’Brien, from Potomac, MD is the              Scholarships are funded by individuals,
Scholarship. Laura is attending the Uni-
                                              winner of the Bemidji Branch Scholarship.         including PHS officers both active and
versity of Notre Dame pursuing a degree in
                                              Caitrin is majoring in Economics-                 retired, COA branches and other organiza-
Civil Engineering. Her COA sponsor is her
                                              Government (Dual) Leadership Sequence at          tions for as little as $250. Persons interested
mother, Captain Josephine E. Divel,
                                              Claremont McKenna College. Her COA                in contributing to the scholarship fund,
                                              sponsor is Captain Thomas R. O’Brien,             want more information or whose depend-
Laura Walsh, from Bethesda, MD is the         USPHS.                                            ents may wish to apply for an award are
winner of the second Captain Ray D.                                                             encouraged to contact Brian McSheffrey,
                                              Andrew McGuire, from Gaithersburg, MD
Crossley II scholarship. Laura has just                                                         the Foundation’s Development Director at
                                              is the winner of the Oklahoma Branch
begun her studies at the University of                                                          1-866-366-9593. He can also be reached at
                                              Scholarship. Andrew is attending the
Virginia, Charlottesville. Her COA sponsor                                            
                                              University of Southern California, working
is Captain Thomas Walsh, USPHS.
                                              towards a degree in Mechanical Engineer-
Tristan D. McGuire, from Gaithersburg,
MD is the winner of the Fort Duchesne
Scholarship. Tristan is attending the
                                              COF and Health Initiatives for Safety and
                                              Stability in Africa (HIFASS) to Collaborate
    In Lieu of Flowers                        T  he PHS Commissioned Officers
                                                 Foundation for the Advancement of
                                                                                                COF and HIFASS to collaborate by sharing
                                                                                                information on public health workforce
       The COF wishes to thank those          Public Health has entered into a formal           topics; meeting at educational sessions
    families, who, in time of mourning,       agreement of collaboration with the Health        sponsored by either organization in order to
    have asked that “In Lieu of Flowers” a    Initiatives for Safety and Stability in Africa    provide a forum for information sharing;
    donation be made to the PHS               (HIFASS) headquartered in Nigeria.                whenever possible, establishment of special
    Commissioned Officers Foundation.         HIFASS is a private sector organization           educational institutes that can facilitate the
    This is a thoughtful and lasting salute   motivated to assist nations to enhance            conduct of short term educational seminars;
    to the contributions made by the ded-     health throughout Africa by the productive        and whenever possible the conduct of joint
    icated members of the Commissioned        use of uniformed service personnel who            research and inquiry studies designed to
    Corps. Thank you for thinking of          may be involved in efforts to improve the         develop fundamental approaches to public
    those who will follow.                    positive health status of citizens of that con-   health workforce enhancement.
       Donations should be sent to            tinent. HIFASS seeks to contribute to the            The agreement was signed for the
    Commissioned Officers Foundation,         education of health professionals who serve       Foundation by executive director Jerry
    8201 Corporate Drive, Suite 200,          the health services delivery and public           Farrell; and for HIFASS by its founder and
    Landover, MD 20785.                       health needs of the nations of Africa.            president, Dr. Roland Oritsejafor, Former
                                                 The three year agreement commits               Minister of Defence (Health), Nigeria.

                                                                                                    OCTOBER 2008 • COA FRONTLINE           15
                           TO ORDER      CALL THE   UNVIVERSITY   OF   ALASKA PRESS
                                    TOLL FREE AT    1-888-252-6657
                               OR ORDER ONLINE AT WWW.UAF.EDU/UAPRESS.

                                  By Robert Fortuine, M.D.
                                 Captain, USPHS (Retired)

                                           DISTRIBUTED   BY THE   UNIVERSITY   OF   ALASKA PRESS.

(Executive Director, from page 1)                already half-over, making it tough to get     Teams were envisioned as a three year
                                                 any new appropriations filtered down          placeholder until the HAMR Teams would
resolution will keep FY 2009 funding at          through the bureaucracy to the folks who      be able to replace them. Year four is
current – FY 2008 – levels. There are            actually have the authority to obligate the   about to begin.
some exceptions where spending under             funds, in time to spend the money before          HAMR teams will eventually, we hope,
the CR would be above the 2008 baseline.         the end of the fiscal year. In many ways,     be populated by officers working directly
Included here are Women, Infants and             it’s a recipe for wasteful spending as the    for, and funded by, the Office of the
Children ($2.9 billion); VA programs ($42        old axiom – “use it or lose it” kicks in.     Surgeon General (OSG). These officers
billion); and BOP ($5.4 billion). Under a                                                      will have as their primary responsibility
CR, funding for the Commissioned Corps                                                         emergency preparedness and crisis
                                                 HAMR Teams on Hold
will remain at FY 08 levels – about $4 mil-                                                    response. They may be assigned in a
lion – and that means transformation is             There is much to be frustrated about
                                                                                               wide variety of jobs as a secondary task.
off the table again.                             by this entire process. High on my list is
                                                                                               HAMR Team members could be assigned
    The next question is how long the CR         the continuing refusal of Congress to fund
                                                                                               to state and local public health depart-
will last. There is not a lot of interest in a   the Health and Medical Response (HAMR)
                                                                                               ments where there is a need for their
lame duck session of the 110th Congress          Teams sought by the Department of
                                                                                               expertise. Team members could be
after the November 4th election. That            Health and Human Services. The HAMR
                                                                                               assigned as adjunct faculty in schools of
means a CR that takes us to March 6th            Team concept took hold following hurri-
                                                                                               public health. Funded through OSG,
according to most observers. If the              cane Katrina in 2005. The deployment of
                                                                                               HAMR Team members, regardless of
Congress makes the CR too unpalatable            some 2000 PHS officers during and after
                                                                                               where assigned, will always be on-call for
for the Bush Administration, the President       Katrina, and the resultant turmoil in the
                                                                                               immediate deployment and will be periodi-
could veto the bill, forcing Congress to         operating divisions and agencies where
                                                                                               cally scheduled for training and exercises.
reconvene in November. If the President          these officers were assigned made it
                                                                                                   The HAMR Teams will not only provide
signs a CR that takes us to March 6th,           clear that the Commissioned Corps need-
                                                                                               a fully trained and readily available public
then the 111th Congress, presumably with         ed a dedicated rapid response capability.
                                                                                               health emergency response capability,
a larger Democratic majority (although all           The gap has been filled since then by     they will also relieve pressure on the
bets are off at this point!), and the next       the tiered Rapid Deployment Force Teams       operating divisions and agencies that will
Administration will have to either pass the      (RDF). RDF Teams have had precious lit-       no longer be forced to endure the
necessary appropriations bills by then or        tle funding for training and team members     unscheduled loss of key personnel.
extend the CR.                                   still have to obtain permission from their
    By the end of March, the fiscal year is      supervisors to participate. The RDF                      (See Executive Director, page 18)

                                                                                                  OCTOBER 2008 • COA FRONTLINE          17
(Executive Director, from page 17)           hurricanes; or some unspeakably evil               The Secretary’s order to “activate”
                                             human act – a terrorist attack – is            the Corps does not simultaneously
   Public health emergency preparedness      required to focus attention on the impor-      relieve supervisors of Corps officers from
was a hot topic in the immediate after-      tance of public health preparedness.           meeting program goals and deadlines.
math of Katrina. But as two more hurri-      Hurricanes Gustav and Ike, sadly, filled       FDA’s CDER does not have its regulatory
cane seasons came and went with little       that bill in 2008. With some 900 PHS           obligations reduced. Patients in IHS clin-
or no hurricane activity threatening the     officers deployed as of the end of             ics still expect to be treated and to be
United States and a host of other press-     September, the operating divisions are         able to have prescriptions filled. Federal
ing issues competing for attention, the      once again feeling the heat.                   Medical Centers do not suspend health
urgency of funding the HAMR teams            Unfortunately, individual officers too often   care for inmates. CDC is still expected
appeared to decline in some quarters.        feel the heat as well for being deployed       to monitor disease outbreaks worldwide
   An unfortunate truth is that too often    regardless of the Secretary’s “activation”     and provide the full level of epidemiologi-
an act of God (or Nature, if you prefer) –   of the entire Commissioned Corps.              cal and other services without missing a
                                                                                            beat. Those are the expectations. The
                                                                                            fact is that something’s gotta give.

                                                                                            NDMS vs HAMR?
                                                                                                So why does Congress keep denying
                                                                                            funding for HAMR Teams, and why does-
                                                                                            n’t DHHS fight harder to overcome that
                                                                                            denial? One reason is that some have
                                                                                            convinced the Appropriations Committee
                                                                                            staffs that HAMR teams duplicate the
                                                                                            functions of the National Disaster
                                                                                            Medical System (NDMS) and are there-
                                                                                            fore, unnecessary and a threat to the
                                                                                            existence of the NDMS. The NDMS is a
                                                                                            system of civilian volunteers who, in time
                                                                                            of crisis, are federalized (compensated at
                                                                                            the GS-15 level) and sent off to provide
                                                                                            short term (two week duration) clinical,
                                                                                            primarily trauma, care (Disaster Medical
                                                                                            Assistance Teams – DMATs). The NDMS
                                                                                            can also deploy Disaster Mortuary Teams
                                                                                            – DMORTs.
                                                                                                The NDMS is organized and operated
                                                                                            within the Office of the Assistant
                                                                                            Secretary for Preparedness and
                                                                                            Response (ASPR) and fills an important
                                                                                            need in responding to calamitous events.
                                                                                            NDMS teams have repeatedly proven
                                                                                            their competence and capability. Their
                                                                                            mission and function, however, is not the
                                                                                            same as that envisioned for the HAMR
                                                                                                First the obvious; HAMR teams do not
                                                                                            include a mortuary capability. While
                                                                                            HAMR Teams may include some trauma
                                                                                            care capacity, the mission is more one of
                                                                                            chronic disease care and restoration of
                                                                                            public health infrastructure. And HAMR
                                                                                            Teams will be in for the long haul. PHS
                                                                                            officers are still deployed along the Gulf
                                                                                            Coast more than two weeks after Ike
                                                                                            struck, and they will be there for some

time to come.                                    RADM Jerry Michael, he and I were able           One Final Note
   Thankfully, there was relatively little       to meet with Senator Dan Akaka (D-HI),
                                                                                                      We have recently become aware of an
loss of life or injury during hurricane Ike,     Chairman of the Senate Veteran’s Affairs
                                                                                                  online “chat room” or forum called “PHS
which left little for NDMS to do. PHS            Committee, on 24 September to discuss
                                                                                                  Chat.” An invitation was sent to all COA
RDF’s meanwhile staffed up temporary             the PHS and NOAA Commissioned Corps’
                                                                                                  local branches to contribute to the forum.
hospitals and began addressing the pre-          exclusion from the Post 9/11 GI Bill.
                                                                                                  The stated purpose of PHS Chat is “to
vention of disease in the aftermath of a         Chairman Akaka could not have been
                                                                                                  serve as an unofficial forum for USPHS
mass population migration, and severe            more gracious or supportive of our con-
                                                                                                  officers and external partners and others
damage to the public health infrastruc-          cerns. He said that there was nothing to
                                                                                                  to exchange and post information,
ture.                                            be done this year (due to the imminent
                                                                                                  express opinions make comments and
   COA will continue to make the case for        adjournment of Congress), but that he
                                                                                                  otherwise communicate about the
HAMR Team funding on Capitol Hill.               was confident this problem can be cor-
Hopefully, we’ll be able to use the recent       rected in the 111th Congress before the
                                                                                                      I want to emphasize that PHS Chat is
examples provided by hurricanes Ike and          new GI Bill goes into effect in August,
                                                                                                  in no way, shape or form associated or
Gustav to relieve the concerns expressed         2009.
                                                                                                  affiliated with COA. We have no idea who
by some well-connected NDMS volunteers              The Senate Veteran’s Affairs
                                                                                                  is behind PHS Chat and we should all be
to Appropriations Committee staff.               Committee is responsible for writing the
                                                                                                  cautious about invitations issued anony-
Something’s gotta give.                          technical corrections bill that will be
                                                                                                  mously. COA remains the sole independ-
                                                 used to correct the omission of the two
                                                                                                  ent voice for Commissioned Corps offi-
Late Breaking News                               Corps. We are extremely grateful for
                                                                                                  cers and Frontline is a vehicle to express
                                                 Chairman Akaka’s time and considera-
   It looks like the FY 2009 National                                                             opinions and exchange information, etc.
                                                 tion – especially in consideration of the
Defense Authorization Act will pass before                                                        about the Commissioned Corps in a pro-
                                                 fact that he also sits on the Senate
Congress adjourns. The NDAA contains a                                                            fessional manner.
                                                 Banking Committee which was trying to
3.9% pay raise for the uniformed services
                                                 resolve the financial crisis the same day
effective 1 January 2009.                                                                         Yours Aye!
                                                 he met with us.

Late Breaking News #2
   Thanks to the good offices of retired

(Force Management, from page 13)                 their forces into a variety of operational and   two-star flag officers are never more than
                                                 administrative entities so there is almost       two or three echelons or levels removed
are their deputy’s – all of whom should                                                           from the four star CNO or combatant com-
                                                 always a dual chain of command. These
therefore be included as PHS flag designat-                                                       mander. The PHS is a much smaller force
                                                 forces can be further “task oriented” to meet
ed billets – on the published list. The                                                           and the distribution of flag rank officers
                                                 differing mission specific objectives. The
Regional Health Administrators who also                                                           should not result in any greater echelon sep-
                                                 level of command of these forces generally
function somewhat as numbered fleet or at                                                         aration for PHS flags then their peers in the
                                                 depends on several factors – size of the
least task force commanders, and are all flag                                                     Navy.
                                                 organization, span of control, resources allo-
positions, also ought to be included on the                                                            And this leads to the much larger issue
                                                 cated (budget), mission and more.
list. In the Navy, all the flag billets are on                                                    of where the Surgeon General and the
                                                     In the Navy, you would never deploy an
one list. The only difference is at the com-                                                      Commissioned Corps fit into the DHHS
                                                 aircraft carrier battle group – anywhere from
batant commander level – the joint com-                                                           organizational model. Perhaps there are
                                                 three to seven or eight ships, planes, and
mands were leadership can rotate among the                                                        some needed changes there too. More on
                                                 10,000 or so Sailors – without a one or two
armed services.                                                                                   that another time.
                                                 star flag officer in command. But the Navy
    The Navy has “Type” Commanders that                                                               The PHS Commissioned Corps needs to
                                                 almost always deploys an amphibious strike
work for the fleet commanders. The Surface                                                        get the Corps’ stars aligned properly and the
                                                 group – two to three large deck amphibious
Force Commander, for example, is responsi-                                                        only way to do so is by installing a billet
                                                 ships, two to four escort ships, and aviation
ble for the training, outfitting, maintenance                                                     based force management system for the flag
                                                 assets with about 7,000 or so Sailors – with
and overall combat readiness of all the sur-                                                      officer billets – one that is consistent and
                                                 a captain in charge.
face ships (except aircraft carriers). The                                                        reasonably constant; a source of strength,
                                                     The point is; if you want to use the
PHS equivalents are the Chief Professional                                                        solidarity, purpose, mission and goal orient-
                                                 Navy’s process, then you have to use the
Officers. Now clearly there is an issue here                                                      ed. Not a system that fosters confusion and
                                                 Navy’s organizational model too. Otherwise
having to do with span of control and need                                                        uncertainty among the most senior leaders.
                                                 the process will produce results that don’t
for flag rank.                                                                                    We can do better and we must.
                                                 make any sense. In the Navy, the one and
    The numbered fleet commanders divide

                                                                                                     OCTOBER 2008 • COA FRONTLINE           19
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  except a combined issue January/February and July/August               COA FRONTLINE
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  by the Commissioned Officers Association of the United
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